title: Minimally invasive myomectomy using unidirectional knotless barbed suture.
abstract: OBJECTIVE
  To demonstrate the technique for closure of the uterine wall defect during minimally invasive myomectomy using unidirectional knotless barbed suture.
  
  
  METHODS
  Step-by-step explanation of the technique using videos and pictures (educational video).
  
  
  METHODS
  Women have a 70% to 80% lifetime risk of developing uterine leiomyomas. Myomectomy is a common procedure performed for conservative treatment of leiomyomas that is frequently performed using a minimally invasive technique. Knotless barbed sutures have recently been used successfully in minimally invasive myomectom procedures. Advantages of using barbed sutures in this setting include the ability to perform knotless suturing and rapid suture deployment, which may result in decreased operative time and blood loss. In addition, the tensile strength of the suture is maintained by the barbs, which facilitates the operative procedure and may potentially lead to a more even distribution of tension along the closure.
  
  
  METHODS
  Closure of the uterine wall defect using unidirectional knotless barbed suture during minimally invasive myomectomy.
  
  
  CONCLUSIONS
  The use of unidirectional knotless barbed suture substantially facilitates closure of uterine defects during minimally invasive myomectomy and may offer additional advantages such as minimizing operative time.
authors.affiliation: Obstetrics, Gynecology and Women's Health Institute, The Cleveland Clinic, Cleveland, Ohio. Electronic address: sotoe@ccf.org.
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto
authors.affiliation: Obstetrics, Gynecology and Women's Health Institute, The Cleveland Clinic, Cleveland, Ohio.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Flyckt
authors.affiliation: Obstetrics, Gynecology and Women's Health Institute, The Cleveland Clinic, Cleveland, Ohio.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
mesh_terms: D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013536:Suture Techniques; D013537:Sutures; D063186:Uterine Myomectomy / Q000379:methods*
keywords: Barbed suture; Laparoscopic; Minimally invasive gynecologic surgery; Myomectomy; Robotic